Hospital’s cardiac cath lab saves lives

November 10, 2012

MARTINSBURG - City Hospital's cardiac catheterization lab has a saying: Time is muscle.

According to Lynnette Dalton, director of cardiovascular services, when a patient experiences a heart attack and requires an emergency cardiac catheterization, the clock to unblock an obstruction starts ticking immediately.

"You have a window of opportunity to get bloodflow back to that heart muscle or you have damage," Dalton said. "And once you have damage, these people's lives are forever changed."

Article Photos

Journal photo by Holly Shok Cardiovascular Technician Doug Langager prepares the state-of-the-art equipment in City Hospital’s cardiac catheterization lab, where close to 80 emergency cardiac catheterizations have been performed this year.

In addition to close to 80 emergency cardiac catheterizations this year to date, the full-service, 24/7, state-of-the-art cath lab sees approximately 300 diagnostic catheterizations and cardiac care procedures per year.

With heart disease being the No. 1 health problem in the nation, cardiovascular technician Doug Langager said offering a cardiac cath lab for a region this size is fundamental.

However, this service wasn't always available to the community, he said.

"We would either have to give them blood-clotting medicine and sit on them, which basically is the term, or send them down the road to Winchester Medical Center," Langager said. "With time being muscle, the time lost could be devastating to a patient."

In June 2009, West Virginia University Hospitals-East opened a temporary cath lab offering diagnostic catheterizations only. October 2010 saw the launching of the hospital's cardiovascular center - part of WVUH-East's $31 million three-fold expansion and renovation project - that features seven holding rooms for pre-and post-procedure patients in addition to the 12,000-square-foot cath lab. Four coronary-care recovery beds were also added to the Intensive Care Unit.

"At this point in the road we were able to give the community something they'd really never had," Dalton said.

According to Dalton, when a patient experiences a heart attack, referred to as an ST-Elevation Myocardial Infarction (STEMI), heat obscures in a blood vessel that is not allowing blood to flow to the muscle. Muscle, she said, requires bloodflow and oxygenation or it stops functioning.

During an average STEMI, 17 points of time are measured - starting from field activation, which is notification of the cath lab team - and the national standard for door to "balloon time," Dalton said, must be 90 minutes or less.

"Our goal is to get in there, see what the obstruction is, get it opened and get blood flow reestablished to that muscle," she said. "If you think of the kinked garden hose, we want to get water flowing again."

The cath lab's patient population, Dalton said, ranges from adults in their early 20s to mid-90s. Modifiable risk factors, such as obesity, and inherited risk factors play a role in person's proneness to a heart attack.

The cardiovascular center team hopes 2013 will bring the construction of another cath lab, Dalton said. The center currently has a space carved out for another lab; funding, patient demand and time are the only factors standing in the way of its implementation, she said.

In the meantime, the hospital is grateful to be able to better serve the needs of the community, Dalton said.

"If this wasn't here, you could go ahead and add over an hour additional delay on that muscle getting blood flow," she said. "From being on the other end of that, you're not going to get the outcome that you want."

According to Dalton, those experiencing heart attack warning signs - chest pain or discomfort that lasts for more than a few minutes; pain in the neck, jaw, arms or upper back; abdominal pain or feeling of heartburn; cold sweats or clammy skin; unusual tiredness or nausea; dizziness or lightheadedness; and shortness of breath - should activate the use of the 911 system and not attempt to drive to the hospital.

Emergency responders are equipped to transmit EKG readings to the hospital, in effect notifying the cath lab team of incoming heart attack patients - shaving, on average, 22 to 26 minutes off the total emergency cardiac catheterization time.

"As everybody knows, you've got one heart," Dalton said. "It's life-changing for a patient not to get the care they need."